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Walkom: McGuinty and the politics of a deadly infection

Even before patients started dying from C. difficile, Niagara-area residents were angry at their hospital authority &ndash; and Queen&rsquo;s Park.

George Jardine and other protestors in a health care rally gather July 6 outside the Greater Niagara General Hospital in Niagara Falls, one of three area hospitals experiencing clusters of C. difficile cases. (SARAH DEA / Toronto Star) | Order this photo

For Ontario Premier Dalton McGuinty, there is never good news. The C. difficile outbreak in Welland, St. Catharines and Niagara Falls is the latest example.

The deadly bacteria have already killed 17 patients in area hospitals. That in itself is grim. But the politics of the Niagara region’s health system are equally toxic.

For three years, local residents and their elected councillors have been engaged in a kind of guerrilla war with the Niagara Health System (which runs the region’s seven hospitals) and its overseer, the area’s local health integration network.

Behind both of these bureaucratic bodies, in the crosshairs of voters preparing for October’s provincial election, sits McGuinty’s Liberal government.

For hospitals and their patients, Clostridium difficile is a dangerous and growing scourge. The Ontario Health Ministry reports that, in May, 341 people were infected across the province. Some 40 major hospitals — including five in Toronto — had infection rates above the provincial average.

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However, the Niagara area outbreak is unusual in two respects. First, it is more serious. In May, the infection rate at one St. Catharines hospital was more than eight times the provincial average.

Second, the region’s hospitals are in the midst of a wrenching and unpopular restructuring. Emergency rooms are being closed. Acute care beds are being cut back. Certain kinds of services — such as maternity wards — are being eliminated from entire communities.

So it should come as no surprise that there were public demonstrations this week in St. Catharines.

There are calls for an independent investigation on how hospitals handled this specific outbreak. But regional councillors also want Queen’s Park to slap a moratorium on the Niagara Health System’s so-called hospital improvement plan. Welland council is seeking legal advice on how to torpedo the plan.

Even Ontario Ombudsman André Marin has been involved. Last year, he slammed the local health integration network that oversees the system, saying it approved Niagara’s hospital restructuring scheme without sufficient public input.

McGuinty’s government is involved in two ways.

First, it insists that hospitals stay within their budgets. That’s fine. But when hospitals exceed these budgets — as those of the Niagara system were doing — the pressure is on to make cuts.

The Niagara Health System’s solution was to close emergency rooms in Fort Erie and Port Colborne, eliminate maternity and other services from Niagara Falls and concentrate more medical activities in St. Catharines.

It called all of this creating “centres of excellence.” Residents were furious.

The second way in which McGuinty is involved comes through the local health integration networks themselves. These were designed by the Liberals to co-ordinate health care and ensure money was spent wisely.

Politically, they were supposed to take the rap for cutbacks in health services.

But instead, these so-called LHINs have become lightning rods for discontent. Marin’s blistering report last year painted the Hamilton-Niagara LHIN as secretive and elitist, made up of people whose idea of consulting the public was to have casual conversations with friends while playing golf.

In the latest C. difficile outbreak, all of these strands have come together. The protesters in Niagara aren’t just angry that people have died. Many are infuriated by what they see as a remote and bureaucratic hospital system.

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